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$73-7so-onza City of Zephytfiilts Permit Application Fax 813-7$0-0421 <br /> > r <br /> , Building Department <br /> i . <br /> )ate RecAived ' phone Contact for Permittin � � .� Z�� – U �' J <br /> )wner's Name ��L !a.)� k��1�' �F�� Owner Phone Number ����/ � � v��r� <br /> �' � � <br /> �wner's Address '� Owner Phone Number <br /> °ee Simpte Tittehotder Name �— � Owner Phone Number � � <br /> 'ee Simple'fitlehatder Address <br /> tOB ADDRESS � ��ZJ?r !'� '�J�� c-3 L5 t� LOT# � <br /> 'sUBDIVIS101�! '!�,��j�Ci ca.{.GJ r3� 1�.t}��t' � PARCEL ID# <br /> (OBTAINED FROM PRbPERTY TAX NOTICE) <br /> NORK PROPQSED NEW CONSTtt RDDtA�T C� S1GfV Q Q DEMO�.ISH <br />�� WSTALL REPAIR <br />, 'ROPOSED USE Q SFR [[� GOMM � OTNER <br /> tYPE OF GON8TRUCTION Q BLOCK Q FRAME � STEEL Q <br /> }ESCRtPT10N OF WORK �� I�1}f}�' S 1��IJ6 t;�'S <br /> 3UILDING SIZE I Zf t�(� � SQ FOOTAGE �6�� HEIGHT �.,,,�� <br /> OBUILDING $ �-� �A�t1ATICiN OF TOTAL CONSTRUCTION <br /> � <br /> QELEGTRICAI �>� AMP SERVIGE Q PRflGRESS ENERGY Q Vit.R.E.C. <br /> QPLUMBING ($ � <br /> � <br /> QMECHANICAL $ � VAL.UATION OF MEGHANICAt INSTALLATION ���J� <br /> �� y <br /> OGAS �] ROOFING Q SPECIALTY � OTHER <br /> 'tNiSHED FLOOR ELEVATIONS �� FLOOD ZONE AREA [�YES NO <br /> 3WL.DER ��f COMPANY 2:�?)L L�'� �� ,�'(� � <br /> i1GNATURE `/� ,;� �J��,r,,,�{�j�,.� REGISTER�b Y/ N FEE CURRE� � Y/N <br /> Address L�cense# �— � <br /> eLEGTRiCtAP! COMPANY <br /> i1CyNATURE _ r_ REGISTERED Y J N FEE CURRE� Y/N <br /> Address �tcense# �� � <br /> 'LUMBER COMPANY <br /> i1GNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address I.icense# �— �� <br /> �ECHANICAL CQMPANY <br /> �EGNATURE REGISTERED Y J N FEE GURRE� Y/N <br /> Address License# �� � <br /> ITHER COMPANY <br /> i1GNATlIRE REGISTEREd Y J IV FEE CURREr Y I N <br /> Address _ Uaense# �— �� <br /> ;ESIDENTIAL Attach(2)Plot Plans;(2)sets af Building Plans;(1)set of Energy Forms;R-O-W Permtt for new construction, <br /> Mlnlmum ten(10}work3ng days after submlttal date. Required onslte,Construation Plans,Stormwatar Plans w!Silt Fence instaNed, <br /> Sanitary Facillties&1 dumpster;Site Work Permit for subdivisfons/large projects <br /> �bMMERCIAL Attach(3)complete sets of Building Plans plus a Ltfe Safety Page;(1)set of Energy Forms.R-O-W Permit for new consUucBon. <br /> , Min€mum#en{14}worfcing days after submi#tal date. 12equired onsite,ConstrucEion Ptans,S#ormwater Plans wl Silt Fence instailed, <br /> Santtary FaciliNes&1 dumpster.Site Work Permit for all new proJects.All commercial requirements must meet compliance <br /> , IGN PERMIT Attach{2)sets of Engineered Plaas. <br /> I '*'*PROPERTY SURVEY required for ai!h1EVit construction. <br /> �Irectlons: <br /> Fi11 aut application completely. -" <br /> i Owner&Contractor sign back of application,notarized ' �• r'� ' � � <br /> i <br /> If over�2500,a Notfae of Commencement!s required. {A/C'u�grades ov�er$75Q0} . � ;,�;` <br /> ' Agent(for the contraator)or Pawer of Attomay(for the owiier)'wou�d be someone with notanzed letter from awner aukhorizing same.�� ! " <br /> �VER THE COUNTER PERMlTTING (Front of�Appltcation Only}� . `� � , ' � � - , � <br /> eraofs if shingles Sewers Service Upgrades AJG - Fences.(Piof/SurveylFootage} - ' � � � <br /> ' ,.., �..':. :. <br /> Qr{veways-Not over Counter if on pubOc roadwa}rs:needs RQW"" '��' ` � " ' �� '� �� ` � '� <br />